Bergen Medical Alliance PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BERGEN MEDICAL ALLIANCE PA

Doing business as

Bergen Medical

Practice address

180 Engle St
Englewood, NJ 07631-2507

Phone

(201) 567-2050

Fax

(201) 567-5070

NPI assigned

Jul 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Masiello, CMPE

Title

Coo

Phone

(201) 567-2050

Specialties & licenses 4

Addresses

Other names 1

• BERGEN MEDICAL Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1669495099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312507",
            "telephone_number": "201-567-2050",
            "fax_number": "201-567-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312507",
            "telephone_number": "201-567-2050",
            "fax_number": "201-567-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN MEDICAL ALLIANCE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "MASIELLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "201-567-2050",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BERGEN MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.